MEDICARE: DR. VALERIE DAO NGUYEN DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	53018	CA

General Provider Information

NPI Number	:	1205978897
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. VALERIE DAO NGUYEN DMD

Provider Business Mailing Address
First Line	:	9742 LENORE DR
Second Line	:
City	:	GARDEN GROVE
State	:	CA
Zip	:	92841-4929
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	630 S MAIN ST
Second Line	:	SUITE #C
City	:	SANTA ANA
State	:	CA
Zip	:	92701-5777
Country	:	US
Telephone Number	:	714-835-7030
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2007
Last Update Date	:	08/10/2015

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